CQI – It Doesn’t Stand for ‘Cardiologists Quietly Indoctrinated’

CQI stands for Continuous Quality Improvement, but to achieve cardiology CQI requires that everyone, including the physicians, adapt and change to the new program.  

We all know that changing our behavior can be challenging in the best of circumstances! Trying to achieve clinical, financial or operational improvement through staff behavioral changes can therefore be a daunting task.  It is virtually impossible without access to detailed and accurate information about ourselves that can be used while our actions are still fresh in our minds. Because each cardiology subspecialty (electrophysiology, Echo, Cath Lab, Non-Invasive, TAVR, surgery, etc.) typically works with unique technology and IT systems, meaningful and actionable information is highly unlikely to be found in any one system or data warehouse. This is compounded by the fact that cardiologists will need to access clinical, operational and financial data elements that are likely in numerous non-cardiology back office IT systems they might not be able to access.

CQI behavioral changes require a decision support tool that supplements the cardiologist’s clinical expertise by enabling decision making based upon information from yesterday’s patients, not just last months or last years. This is the essence of CQI and the nature of real-time understanding and the actionable information needed to achieve it. Service line managers should be able to provide their cardiologists with the ability to, at a minimum, enable:

  • Measuring the clinical value and productivity impact of their diagnostic cardiology efforts.
  • Obtaining timely and continuous feedback that can be used to quickly improve individual productivity and quality performance against personal and group goals.
  • Tracking clinical outcome improvement activities, care information and cost measures that are required to meet ACC continuous quality improvement guidelines.

Maintain Understanding

Achieving CQI, by definition, requires an ongoing effort that reflects a new way of thinking and delivering healthcare. It’s not a one-time correction. It should be a series of ongoing assessment and corrections that gradually move the organization in the desired direction.

As a practical matter, cardiologists are busy and highly compensated providers who don’t have any extra time in their day to analyze the impact of their behavior. Up until now, they frankly have not been compensated to do so, and the incentives have just not existed. So any tool one plans to use in support of these efforts must be easy to use, and able to quickly and easily present relevant information that provides immediate feedback on their contributions and progress towards goals. And it must do this in a way that assures accuracy and builds trust.

An integrated analytics solution like Foundations™ Cardiology enables the cardiologist to easily personalize the measures they need to understand and improve, for example, areas such as:

  • Readmission rates by cardiologist and procedure.
  • Performance metrics for stent usage, cost per vendor and performance of each over time.
  • Restenosis rates for the procedures they have performed over the past 12 months.

CQI is not easy to achieve, and cardiology service line leaders can’t do it alone. The cardiology clinical staff must participate in ways that go beyond registry reporting and reliance on 3rd party tracking. Behavior must change to support new approaches to delivering care that support CGI goals.

In our next blog post we’ll re-examine the analytics needs of the radiology group, but now examining the IT leadership perspective.